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� <br />.-� <br />��� �r <br />���� ��� <br />�� <br />COMMUNITY DEVELOPMENT <br />2660 Civic Center Drive : Roseville, MN 551 13 <br />Phone: (651) 792-7005 : Fax: (651) 792-7070 <br />ADMINISTRATIVE DEVIATION APPLICATI <br />C1TY CODE SECTION 1014.05 <br />www.ci.roseville.mn.us <br />❑ APPLICATION FEE: $75 <br />p C�C�C�OdC� <br />� SEP 21 2009 <br />9 <br />(Fee should be made payafile to City of Roseville upon submittal of �completed application.) <br />Please complete the application by typing or printing in ink. Use additional paper if necessary. <br />1. Property Owner Information: <br />Last name: W a.��r�, First name: GG1�v T� �o� �. <br />Address: �Q �,2. Wl� ��.�v�0�- H,1 �,�� City/State/Zip: '��V � �l °� �:itn.,, S$"l �3 <br />Phone na�mber: 6S� ' i. �'6 '�� � Email address: <br />2. Applicant Information: ('f different from above) <br />Company name: � tIS-�' l'p1�v. GOv�„S-�t`�{ �� V�. <br />Last name: L.a�s�eV� First name: Srbtiv^C. <br />Address: pZ 6 4( o�-Q�`' � v� City/State/Zip: yH,�/,� yV! n�5�� b� <br />Phone number.• (� �c3- 7�Z� I�� Email address: <br />3. Statement of Intent: Briefly describe the project: why is an Administrative Deviation needed? <br />' 1�. c� w� o cJ� �'r t� o w'k' G o rG („ C�..�. �n.o <br />�� <br />4. Additional Required Information: <br />Coh,� �G�C <br />a. Proposed Plans: A scaled site plan is required showing the existing and proposed building <br />footprints as well as driveways, sidewalks, and patios. <br />1) Include elevation drawings showing the proposed addition or new building with structure <br />setback deviation applications. <br />2) Include preliminary storm water miti�ation plans with impervious coverage deviations. <br />b. Written Narrative: Address the factors that must be considered during review of Administrative <br />Deviation applications; these factors are listed in the document attached to this application and in <br />§ 1014.05 of the City Code. <br />5. Signature(s): By signing below, you attest that the information above and attached is true and <br />correct to the best of your knowledge. <br />Property Owner: _�����li . Date: gi'-o�� '�°l <br />Applicant: Date: q� � �� <br />